(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003510181
Provider Name: QUARTIVIA GIBSON
Entity Type: Individual
Taxonomy Code: 363LP0808X
Specialty: Nurse Practitioner
License Number: 905847
Most Important Dates
Enumeration Date: 03/30/2023
Last Updated: 06/09/2023
Provider Practice Location
202 GENERAL GARDNER AVE
LAFAYETTE
LA
705017824
Practice Location Phone/Fax
Phone: 3372329457
Fax:
Provider Mailing Location
5439 BURKHARDT RD
DAYTON
OH
454312111
Provider Mailing Phone/Fax
Phone: 6019101168
Fax: